Neurology in Africa: clinical skills and neurological disorders. Kilimanjaro Christian Medical Centre, Tanzania and Centre for International Health, University of Bergen, Norway
- W. P. Howlett
The aim of this study was to describe the pattern of spinal cord injuries, MRI signal patterns and neurological impairment among spinal cord injury patients in Lagos, Nigeria. A retrospective study of the hospital records and MRI reports of 90 spinal cord injury patients at the Lagos University Teaching Hospital was conducted. The study included patients who presented at the hospital with spinal cord injury between 2006 and 2012. Results showed young to middle-aged male gender and cervical spinal cord injury preponderances. The dominant etiological factor was road traffic accident (60%, n = 54). In ASIA A class, 22.2% (n = 20) had intramedullary cord hemorrhage only while 31.1% (n = 28) had a combination of intramedullary cord hemorrhage and edema. For ASIA B, 6.7% (n = 6) had intramedullary cord hemorrhage only, 13.3% (n = 12) had cord edema only and 2.2% (n = 2) had a combination of intramedullary cord hemorrhage and edema. ASIA C consisted of 8.9% (n = 8) patients who had cord edema only. ASIA D and E categories also consisted of 11.1% (n = 10) and 4.4% (n = 4) patients respectively who had cord edema only. The relationship between pre-treatment classification, MRI findings and neurological status at the end of treatment was of prognostic value in neurological outcome of the patients. In conclusion this study has revealed the pattern of spinal cord injury lesions at MRI in the locality. The dominant lesions were hemorrhage and a combination of hemorrhage and edema. This lesion pattern showed direct relationship with ASIA classification scale for neurological impairment and thus was useful for prognostication of the injuries.